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Biomedical subjects

J Noell

Publications and source records attributed to J Noell.

15 recordsLinked to original sources
PubMed2001

Depression, suicidal ideation and STD-related risk in homeless older adolescents.

Goals of this study were to examine the frequency of depression and related constructs of suicidal ideation and hopelessness in a sample of homeless older adolescents and their associations with behaviors that may increase the risk of sexually transmitted disease (STD). Diagnostic interviews and blood/urine samples were obtained from 523 homeless adolescents (mean age=17.8). Overall, 12.2 per cent had a current DSM-IV diagnosis of major depression and 6.5 per cent had dysthymia, with higher rates for female and older participants. Depression appeared to precede rather than follow homelessness and was associated with biologically verified STDs (in older participants), infrequent condom use, a non-heterosexual orientation (in older participants), and lifetime homosexual experience. Unlike depression, suicidal ideation and hopelessness were associated with higher rates of intravenous drug use but lower rates of multiple sex partners and, in young homeless women, less sexual coercion. Depression is frequent in homeless older adolescents and has a complex association with STD-related behaviors.

Adolescent↗
PubMed2001

Childhood sexual abuse, adolescent sexual coercion and sexually transmitted infection acquisition among homeless female adolescents.

OBJECTIVE: To examine the relationship between childhood experiences of sexual abuse, sexual coercion during adolescence, and the acquisition of sexually transmitted infections (STIs) in a population of homeless adolescents. METHOD: Homeless adolescent females (N = 216) from a northwestern United States city were recruited by street outreach workers for a longitudinal study of STI epidemiology. Baseline data on childhood abuse and recent history of sexual coercion were used to predict physiologically confirmed STI acquisition over the subsequent 6 months. RESULTS: About 38% of all girls reported a history of childhood sexual abuse (CSA). Girls with a history of CSA were more likely to report recent sexual coercion. In turn, sexual coercion in the last three months was significantly associated with a higher number of sexual partners (but not with a greater frequency of intercourse or with lower rates of condom use). Number of sexual partners significantly predicted the future acquisition of an STI within 6 months. CONCLUSIONS: Interventions to reduce risky sexual behaviors in homeless adolescent females may need to consider the impact of CSA, particularly on the number of sexual partners during adolescence. However, it also should be noted that engagement in intercourse often results from coercion and is not voluntary in this population.

Adolescent↗
PubMed2001

Incidence and prevalence of chlamydia, herpes, and viral hepatitis in a homeless adolescent population.

BACKGROUND: High rates of unprotected intercourse and illegal drug use have been reported among homeless adolescents. As a transient population with the potential to act as disease vectors from one location to another, incidence and prevalence of sexually transmitted infections in this population are of particular concern. GOAL: To assess a homeless adolescent population for incidence and prevalence of Chlamydia trachomatis, herpes simplex virus type 2, hepatitis B virus, hepatitis C virus, HIV, and psychosocial correlates of the acquisition of sexually transmitted infections. STUDY DESIGN: Longitudinal with assessments at baseline, 3 months, and 6 months (n = 536; 319 males and 217 females). RESULTS: Baseline prevalence of C trachomatis was 4.17% for males and 6.30% for females. Prevalence of herpes simplex virus type 2 was 5.73% for males and 12.50% for females. Hepatitis B virus and hepatitis C virus prevalences were 3.60% and 5.0%, respectively. HIV seroprevalence was 0.3%. The incidence of sexually transmitted infections was significantly higher among females than among males (16.7% versus 9.8%) and was associated with inconsistent condom use and, for females, number of partners and sex with older partners. Incident hepatitis B virus and hepatitis C virus infection rates were 3.44% and 6.61%, respectively; both were associated with injection drug use. CONCLUSIONS: Among females, the incidence of herpes simplex virus type 2 (> 25%) and C trachomatis (12%) was relatively high. Inconsistent condom use was the primary factor associated with a significantly greater risk of incident sexually transmitted infections. This was especially true for females with multiple partners. Homeless adolescents also are at high risk for hepatitis B virus and hepatitis C virus infection, primarily associated with self-reported injection drug use.

Adolescent↗
PubMed1999

IQ scores among homeless older adolescents: characteristics of intellectual performance and associations with psychosocial functioning.

Intellectual performance and the associations of IQ with the quality of psychosocial functioning were studied in a sample of homeless older adolescents. Fifty homeless older adolescents (ages 16-21) completed the Wechsler Adult Intelligence Scale-Revised (WAIS-R) and a questionnaire assessing psychosocial functioning and sexual risk factors. The WAIS-R scores were comparable to population means, with performance IQ scores tending to be higher than verbal IQ scores. The IQ was unrelated to the duration of homelessness. Higher IQ scores were significantly correlated with only a minority of the measures of psychosocial functioning, including less self-reported depression and lower reported delinquency, but also less self-control in high-risk sexual situations, less perceived peer support for safer sex, and a higher perceived likelihood of acquiring HIV.

Adolescent↗
PubMed1999

Developers and evaluation of interactive health communication applications. The Science Panel on Interactive Communications and Health.

BACKGROUND: Developers of Interactive Health Communication (IHC) are capable of providing great benefit by creating interactive programs that serve to protect and improve health. Conducting proper evaluation of these programs will ensure that they achieve these goals more successfully. CONCLUSIONS: This article seeks to inform developers of IHC about which types of evaluation are most important to include as a part of the development process and to examine the ways in which such evaluation can be implemented to benefit the producers--and ultimately, the consumers--of IHC.

Community Participation↗
PubMed1999

Interactive technology applications for behavioral counseling: issues and opportunities for health care settings.

CONTENT: This article discusses the rationale for, and the potential benefits and limitations of, computer-based interactive health communication (IHC) programs for health behavior counseling. We describe common barriers to health behavior counseling in medical settings and show how IHCs can address these issues. Following an overview of current and likely near-future IHCs, the potential impact of IHCs on the patient-provider relationship is considered. Results from evaluations of IHCs are summarized and important and unique issues in evaluating IHCs are discussed. We conclude with recommendations for clinical applications, including recommendations for consumers considering purchase or adoption of IHCs and recommendations for future research.

Computer Communication Networks↗
PubMed1998

Analytical and clinical performance characteristics of Tandem-MP Ostase, a new immunoassay for serum bone alkaline phosphatase.

The performance characteristics of the Tandem-MP Ostase assay, a new microplate immunoassay for bone-specific alkaline phosphatase (bone ALP; EC 3.1.3.1) in human sera, are described. Bone ALP is bound to streptavidin-coated microwells by a single biotinylated anti-bone ALP monoclonal antibody. Antigen is detected by the addition of p-nitrophenyl phosphate. The assay is performed at room temperature in <90 min. Imprecision was 2.3-6.1% with a detection limit of 0.6 microg/L. Method comparison of bone ALP measurements with the Tandem-MP Ostase assay and the mass-based Tandem-R Ostase assay (n = 285) indicated regression statistics of Tandem-MP Ostase = 1.03 Tandem-R Ostase + 0.22 microg/L, S(y/x) = 4.0 microg/L, r = 0.97. Serum bone ALP values in apparently healthy men and in pre- and postmenopausal women were also similar between the two Ostase assay formats. Liver ALP reactivity determined using the slope and heat inactivation methods was similar in both Ostase assays. Liver ALP reactivity ranged from 3 microg/L (heat inactivation) to 6 microg/L (slope method) per 100 U/L of liver ALP activity, whereas bone ALP reactivity was 37 microg/L per 100 U/L of bone ALP activity, indicating a liver ALP relative reactivity of 8.1-16.2%. Similar results were obtained with the Alkphase-B bone ALP immunoassay. The Tandem-MP Ostase bone ALP assay demonstrated increased concentrations of serum bone ALP in conditions where bone metabolism is increased and showed a rapid, temporal decrease in serum bone ALP in Paget disease patients on bisphosphonate therapy. In conclusion, the Tandem-MP Ostase assay for serum bone ALP is a rapid, simple, robust nonisotopic alternative to the Tandem-R Ostase immunoradiometric assay that provides an accurate and sensitive assessment of bone turnover.

Adolescent↗
PubMed1997

Development and evaluation of a sexual decision-making and social skills program: "the choice is yours--preventing HIV/STDs".

A series of interactive videodisc programs designed to reduce HIV/STD risk behaviors was developed and evaluated. Separate programs were developed for each of three race/ethnicities (African American, Hispanic, and Caucasian) at each of two age levels (middle school and high school) using extensive formative procedures. Each program uses scenarios with extensive branching story lines to teach decision-making skills and socially appropriate responses to potentially risky sexual situations. In a randomized experiment with 827 students, significant changes were observed at posttest for the four constructs assessed: (1) belief that sex occurs as a result of decisions (vs. "it just happens"), (2) belief that even a single incident of unprotected sex can result in an STD or pregnancy, (3) intentions and attitudes toward use of condoms, and (4) self-efficacy in remaining abstinent (i.e., avoiding sex). At 30-day follow-up, three of the four measures remained significant.

Adolescent↗
PubMed1995

Does sexual coercion play a role in the high-risk sexual behavior of adolescent and young adult women?

Sexual coercion and its relationship to high-risk sexual behavior were examined in five samples of young women. Sample 1 (N = 22) consisted of sexually active adolescents aged 15 to 19. Samples 2 (N = 206) and 3 (N = 70) were recruited from among patients at three sexually transmitted disease clinics. Sample 4 (N = 51) consisted of young homeless women living on the street in a large city. Sample 5 (N = 51) was recruited from among young women on a college campus. Across all samples, 44.4% of women indicated that they had been forced into some form of sexual activity against their will. Self-reports of sexually coercive experiences were consistently related to risky sexual behavior. It appears that many young women are coerced into engaging in high-risk sexual behavior. This implies the need for greater attention to male coercive sexual behavior and women's skills for coping with such behavior.

Adolescent↗
PubMed1994

The social context for risky sexual behavior among adolescents.

This study supports a model of adolescents' risky sexual behavior in which this behavior is seen as a product of the same peer and family factors which influence a wide range of problem behaviors. The Patterson et al. (1992) model of peer and parental factors associated with adolescents' sexual risk-taking behavior was tested on three independent samples of adolescents, ages 14 through 18. Adolescents whose peers were reported to engage in diverse problem behaviors were more likely to engage in risky sexual behavior. Poor parental monitoring and parent-child coercive interactions were associated having deviant peers, and poor parental monitoring also had a direct relationship to risky sexual behavior. Family involvement was associated with fewer parent-child coercive interactions. Less availability of parental figures in the family was directly associated with risky sexual behavior and was also associated with poorer parental monitoring.

Adolescent↗
PubMed1992

Measuring children's social skills using microcomputer-based videodisc assessment.

This article describes the development of a microcomputer-based videodisc assessment prototype for measuring children's social skills. The theoretical and empirical foundations for the content are described, and the contributions of interactive microcomputer-based video technology to assessment of children with handicaps are detailed. An application of Goldfried and D'Zurilla's "behavior-analytic" approach to development of the content of assessments is presented, and the related video and computer technology development is detailed. The article describes the conceptual foundations of the psychometrics of the assessment prototype as well as the psychometric methodology that was employed throughout the development process. Finally, a discussion of the potential applications and implications of the social skills assessment prototype is included.

Child↗
PubMed1991

Science instruction at the secondary level: implications for students with learning disabilities.

Designing appropriate content area instruction for secondary students with learning disabilities is a challenging endeavor. Even if these students are mainstreamed into algebra, history, or science classes, special educators are likely to expect only a minimal grasp of the material. To go beyond this, to teach higher order thinking through these subjects, would be regarded by most practitioners as too labor-intensive. The authors of this article argue that, through a comprehensive revision of traditional materials, secondary students with learning disabilities can learn content area subjects--earth science and introductory chemistry, particularly--in an integrated manner. These students can achieve a firm understanding of the subject, as well as learn how to solve complex, domain-specific problems. For this kind of integrated instruction to be feasible, the curriculum must be designed and field-tested by professional curriculum developers.

Adolescent↗
PubMed1990

Social and behavioral factors associated with high-risk sexual behavior among adolescents.

Relationships among risky sexual behaviors, other problem behaviors, and the family and peer context were examined for two samples of adolescents. Many adolescents reported behaviors (e.g., promiscuity or nonuse of condoms) which risked HIV or other sexually transmitted disease infection. Such risky behaviors were significantly intercorrelated. Consistent condom use was rare among those whose behavior otherwise entailed the greatest risk of infection. In both samples, an index of high-risk sexual behavior was significantly related to antisocial behavior, cigarette smoking, and illicit drug or alcohol use. Social context variables, including family structure, parenting practices, and friends' engagement in problem behaviors, were associated with high-risk sexual behavior. Finally, for sexually active adolescents, problem behaviors and social context variables were predictive of nonuse of condoms. Results were consistent across the two studies and regression weights held up well under cross-validation.

Adolescent↗
PubMedDate not supplied

Mathematical modeling of epidemic syphilis transmission. Implications for syphilis control programs.

BACKGROUND AND OBJECTIVES: The past 10 years' wave of syphilis epidemics has challenged syphilis control programs. Although apparently connected to drugs-for-sex trading of crack cocaine, the genesis and resolution of these epidemics is poorly understood. GOALS OF THE STUDY: The goals of this study were to develop a mathematical model of epidemic syphilis transmission based on empiric data, to stimulate and ascertain behavioral and sociologic features necessary to produce epidemic transmission, and to explore mechanisms leading to resolution of epidemic transmission. STUDY DESIGN: The study used multi-compartment iterative computer simulation using empirically derived input data. RESULTS: Epidemic transmission resulted from adding a small core group of individuals with very high levels of partner exchange (300-400 partners per year) to a population with levels of partner exchange seen in the general population. Epidemic resolution could result from immunity or subtle changes in the size or partner exchange rate of the core group. CONCLUSION: There is a need for sexually transmitted disease control programs to reevaluate their approach to prevention and control of epidemic syphilis in light of data on transmission dynamics.

Adolescent↗